PMT15-03072 City of Menifee Permit No.: PMT15-03072
29714 HAUN RD.
'!CCEl.A7. MENIFEE, CA 92586 Type: Residential Demolition
MENIFEE Date Issued: 10108/2015
PERMIT
Site Address: 25630 PAPILLON CT, MENIFEE, CA Parcel Number: 329-380-039
92585 construction cost: $4,310.00
Existing Use: Proposed Use:
Description of DEMO SLAB FOUNDATION
Work: TR 29495-7
LOT 22
Owner Contractor
STRATA CVE, LLC MENDOZA GRADING&PAVING INC
4370 LA JOLLA DRIVE,STE 960 11259 JUNIPER AVENUE
SAN DIEGO,CA 92122 FONTANA,CA 92337
Applicant Phone:9098220738
FH II, LLC License Number: 1002375
MENIFEE, CA
Fee Description Qtv Amount f81
Building Permit Issuance 1 27.00
Demolition Permit 1 140.00
GREEN FEE 1 1.00-
$168.00
The issuance of this permit shall not prevent the building official from thereafter requiring the correction of errors in the plans and
specifications or from preventing builiding operations being carried on thereunder when in violation of the Building Code or of any other
ordinance of City of Menifee.Except as otherwise stated,a permit for construction under which no work is commenced within six
months after issuance,or where the work commenced is suspended or abandoned for six months,shall expire,and fees paid shall be
forfeited.
AA_eldg_Penit Template.rpt Page 1 of 1
City Of Menifee
IREN5"�E�`l10CL � N -
❑ I am exempt from Imensure under the Contractors!State License Law for the
I hereby affirm under penalty or perjury that I am licensed under provisions of following reason:
Chapter 9(commencing,With section 7000)of Division 3 of the Business.and By my signature below I acknowledge that,except for my personal residence in
PrMe.ssivons G0 e' d my license Is In full force and effect t1/ which 1 must have resided for at Ideal one year prior to completl6h of
rlt 'O -8X esrfi t I8"��f�sj3 loj'. JCS I!n Improvements covered by this permit;I cannot legally Sell a strnrcN a that I have
-•qyt ,, '$( 2At"7t'^$t�nat�i built as an owner-bullding if it has not been constructed in its entirely by licensed
a <, contraclors'.I understand that a copy of the applicable law,Secllon 7044:of the
GVO ERSyG r MRE 9ftT1D DL T Business and Prolesslons Code,Is available upon request when This application is
submited or at the following Web site:
❑ 1 hemlly ahirm under penalty of perjury one of the:following declarations: n
have and will maintain a certificate of consent of seiKinsure for workers' hgg•IAw!w leei fc ca eovlcalaw.Hlml.
compensation;Issued by the Director of Industrial REYatons as provided for by Date
Section 3700 of the Labor Code,for the performance of work for which this
permit Is
I� ssued. - Property Owner orAuth.o*gd Agent
P1'3t+1�y R.By my Signature below, I cedify to Apph of the following: I am the properly
�y,(A I have and will maintain workers' compensatien Insurance, as regdired by owner or authorized to act on the property owner's behalf. I have read this
XseLVon 3700 of the Letior Coda, for the performance.of.the work for which Ihi; application and the Information I have provided is correct. 1 agree to comply
permit is issued.My workeWparhperis2ton insurance carrierand policy number are: with all applicable city and county ordinances and stale laws relating to Building
-T'• 1 donsIfdc&.I authorize representatives of this city or county to enter the above.
Identified property for the Inspection purposes.
�1� Date
Raga 1sn�—� PrdpattyOwnerorAptlipriiedAgent
(This Section need not Ile.compieted if the permit Is for city Business Ucense ik
one-Hundred dollars($100)or less) -
HAZARDOUS MATERIAL DECLARATION
❑ I certify that In the performance of the Work for canton This permit is Issued,I
.shall of a"""`lo an yy person'In any manner sp As to become subject fp.(he Wjll the applicant or future building occupant handle hazardous material or a
Wofkers'cpmpan sat ton lawsof California,and agree that if I shoulo become mixture containing ahazardous material equal to or greater that the
subject to the Workers'compensation provisions of Seaton 3700 of the Labor .amounts sp'edlfled on the Hazardous Materials Information Guide?
Code,I shell foAhwith com with those provisions. _ IlAfs d NO
Appca rr. }rev,SLC> OIs WIIltheinten'ded use of the building bytei applicant orfulumbullding
occupant require a penhitfor the cohstruclion.or modification from South
WARNING: "OVERAGE
TO SECURE WORKERW Coast Air Quality Management District(SCAQMD)7 See permitting checklist
COMP.ENSA ION OVERAGE is UNLAWFUL AND SHALL for guideline's
SUBJECT .AN EMPLOYER TO .f:RIMINAL. PIE�J..CTIES AND DYES O.NO
CIVIL FINES UP TO:ONE HUNDRED.THOUSAND*DOLLARS
($Ago,0_0D),-IN ADDITION TO THE COST OF COMPENSATION, Will the proposed building ormodified facility be within 1000 feet of the outer
DAMAGES AS PROVIDED FOR IN SECTION 3706`OF`THE boundary dfa:.schcol7
LABOR:CODE,INTEREST,AND ATTORNEYS FEES' DYES ONO
CONSTRUCTIOWLENDING AGENCY I have read the Hazardous Material Information Guide arid the SCAQMD
I hom4yafflrm that under he penally of perjury there is 9 construction lending permitting'checkllst. I understand my requirements under the State.oI
agency for the performance of the work which this permit Is Issued(Section Callfomle Health&Safety Code,Section 25505 and 25534 concerning
$o97 Civil Code) hazardous material reporting.
OWNER BUILDER DECLARATIONS DYES ❑NO
thereby affirm under penally of perjury that I am exempt from the Contractor's -
Date
Ucense Law for the reason(s)Indicated below by the checkrnark(s)I have placed PROPERTY OWNER DR AUTHORIZED AGENT
next to the applicable item(s)(Section 7031.5 Business and Professions Code:
requires
Any city or county that a permit to constfiiciralter, improve, demolish, -EPA-RENOVATION.REPAIR AND PAINTING(RRP)
or repair any structure;prior to its Issuance,also requires the applicant for the
permit to file a signed'statement that he or she is licensed pursuant to the The EPA-Rendvatlon,Repair and Painting(RRP)Rule requires contractors
provlslons of the Contractor's State License Law(Chapter 9(commencing with receiving compensation for most work that disturbs paint In a pre=1978
Section,7000)of Division 3 of the Business and Professions Code)or that he or residence:or childcare facility to be RRP-certilled firms and comply with
she is. exempt from licensure and file basis for the alleged exemption.Any required practices.This Includes rental property owners and property
violation of Section 7031.5 by any Applicant for a permit subjects the applicant to managers who do the paint-disturbing work themselves or through their
a civil penally of not more than($500).) employees.For more information about EPNs Renovation Program visit:
www.'epa.gov/lead or contact the National Lead Information Center at
❑ I, as owner of the property, or my employees with wages as their sole 1.800-424-LEAD(5323).
compensation,will do( )all of or( )porting of the work,and the strpeture Is
not Intended or offered for sale:(Section 7044,Business and Professions Code;
The Contractor's State Ucense.Law does not apply to an owner of a property ❑An EPA Lead-Safe Certified Renovator will be responsible for this project
who, through employees' or personal effort,builds or Improves the property,
provided that the Improvements are not Intended or offered for sale.If,however. Certified Firm Name:
the building or Improvement Is sold within one year of completion,the Owner-
Bullder.will have the burden of proving that II was not built or improved for the Firm Certification No.:
purpose of sale).
❑ I, as owner of the property an exclusively contracting with licensed ❑No EPA Lead-Safe Certified Firm Is required for this project because:
contractors to construct the project(Section 7044,Business and Professions
Code:The Contractor's License Law does not apply to an owner of a properly
who builds or improves thereon,and who contracts for the projects with a
licensed contractor(s)pursuant to the Contractors State License Law). If your project does not comply with EPA RRP rule please fill out the RRP
Acknowledgement.
i
BUILDING & SAFETY PERMIT/PLAN CHECK APPLICATION
Menifee
DATE 10/01/2015 PERMIT/PLAN CHECK NUMBER
TYPE: ❑COMMERCIAL ❑✓ RESIDENTIAL []MULTI-FAMILY ❑MOBILEHOME POOL/SPA ❑SIGN
SUBTYPE: ❑ADDITION []ALTERATION ❑✓ DEMOLITION ❑ELECTRICAL []MECHANICAL
[-]NEW [-]PLUMBING FIRE-ROOF-NUMBEROFSQUARES
DESCRIPTION OF WORK Demolish existing concrete slab for Lot No.vlof Tract No.29495-7
PROJECTADDRESS ��7� /(/.JL- �/n,/(�C
ASSESSOR'S PARCEL NUMBER,5� l-S- 4160 CZCt LOT /, /� TRACT `-`7 Y -1 J��
PROPERTY OWNER'S NAME STRATA CVE,LLC;Strata Equity Group, Inc.
ADDRESS 4370 La Jolla Drive,Suite 960,San Diego,CA 92122
PHONE EMAIL
APPLICANTNAME FH II, LLC
ADDRESS 8300 Utica Ave,Ste 300, Rancho Cucamonga, CA 91730
PHONE (909)354-8000 EMAIL ttucker@frontier-enterprises.com
CONTRACTOR'S NAME Mendoza Grading&Paving, Inc. OWNER BUILDER? ❑YES❑✓ NO
BUSINESS NAME Mendoza Grading&Paving, Inc.
ADDRESS 11259 Juniper Avenue; Fontana,CA 92337
PHONE (909)822-0738 EMAIL everett@mendozapaving.com
CONTRACTOR'S STATE LIC NUMBER 1002375 LICENSE CLASSIFICATION C-12
VALUATION$ $4.310.00 SO FT 2155 L SO FT
APPLICANT'SSIGNATURE- DATE 1 0/0112 0 1 5
CITY STAFF USE ONLY
DEPARTMENT DISTRIBUTION CITY OF MENIFEE BUSINESS LICENSE NUMBER
BUILDING PLANNING ENGINEERING IRE REEN SMIP A-
INVOICE - PAIDAMOUNT
AMOUNT OCASH O CHECK R OCREDIT CARD VISA/MC
PLAN CHECK FEES PAID AMOUNT O CASH O CHECKN O CREDITCARD VISA/MC
OWNER BUILDER VERIFIED O YES O NO DL NUMBER NOTARIZED LETTER O YES O NO
City of Menifee Building&Sofety Deportment 29714 Houn Rd. Menifee, CA 92586 951-672-6777
www.cityofinenifee.as Inspection Request Line 951-246-6213
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